WO2019142215A1 - Forceps endoscopique à trois mâchoires - Google Patents

Forceps endoscopique à trois mâchoires Download PDF

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Publication number
WO2019142215A1
WO2019142215A1 PCT/IT2018/000005 IT2018000005W WO2019142215A1 WO 2019142215 A1 WO2019142215 A1 WO 2019142215A1 IT 2018000005 W IT2018000005 W IT 2018000005W WO 2019142215 A1 WO2019142215 A1 WO 2019142215A1
Authority
WO
WIPO (PCT)
Prior art keywords
jaws
stent
forceps
extraction
endoscopic
Prior art date
Application number
PCT/IT2018/000005
Other languages
English (en)
Inventor
Fiorelli ALFONSO
Original Assignee
Alfonso Fiorelli
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Alfonso Fiorelli filed Critical Alfonso Fiorelli
Priority to PCT/IT2018/000005 priority Critical patent/WO2019142215A1/fr
Publication of WO2019142215A1 publication Critical patent/WO2019142215A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22031—Gripping instruments, e.g. forceps, for removing or smashing calculi
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22031—Gripping instruments, e.g. forceps, for removing or smashing calculi
    • A61B2017/22035—Gripping instruments, e.g. forceps, for removing or smashing calculi for retrieving or repositioning foreign objects
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws

Definitions

  • the present invention consists of an endoscopic forceps dedicated to the extraction of tracheobronchial silicone prosthesis positioned for the endoscopic treatment of stenosis of the trachea or bronchi. Therefore, it can be used advantageously in endoscopic surgery operations.
  • the peculiarity of this forceps which makes it unique and innovative compared to all the other two-jaws endoscopic forceps, is represented by three jaws located at the proximal end.
  • the outer face of each jaw is smooth and atraumatic, while the inner face has a wavy indentation that ends with a tooth.
  • This internal structure allows the prosthesis to be firmly held once it has been closed between the jaws of the forceps, reducing its caliber in order to extract it easily, effectively and safely, such as pulling a wine cork out of the bottle, even in particularly difficult conditions.
  • the tracheo-bronchial tree consists of the lungs and the airway (the trachea and bronchi) through which the air reaches the lungs.
  • the trachea is an organ of the respiratory system having the form of a hollow cylinder, about 12 cm long, whose main function is to allow the passage of air from the larynx to the bronchi.
  • Different pathological conditions can cause a narrowing of the diameter (stenosis) of the trachea or of the bronchi, with a consequent reduction in the passage of air to the lungs and respiratory failure.
  • a possible intervention for the restoration of the normal airway patency is the dilation of the trachea through the use of a rigid bronchoscope that, through airway manipulation, allows the resolution of the stenosis and the positioning of an endobronchial silicone prosthesis, also known with the name of "stent", which has the task of keeping the trachea opened and preventing it from closing and recurrence of stenosis.
  • the stent especially in benign stenosis, remains in place for a limited period of time (about 1-2 years) and is subsequently removed in order to prevent that the infections take place and to verify if the trachea, cicatrized by now, can remain opened even without the stent.
  • a surgeon introduces the rigid bronchoscope, through the mouth, into the airways (trachea and main bronchi), by hyperextension of the supine decubitus head; an endoscopic forceps is introduced through the rigid bronchoscopy into the trachea, grasps the proximal end of the stent, wraps the same over it and, after having reduced its diameter, proceeds to its extraction through the rigid bronchoscope.
  • the silicone in contact with the tracheal secretions could lose its elasticity and become rigid.
  • the chronic inflammation of airway mucosa could create tenacious adhesions between the external wall of the prosthesis and the tracheal mucosa. All these conditions make particularly difficult to extract the stent using the standard technique.
  • the present invention has elements in common with other endoscopic forceps such as, ring handle, a lock system, a wheel to rotate the jaws and orient them so as to easily surround the stent.
  • ring handle a lock system
  • a wheel to rotate the jaws and orient them so as to easily surround the stent.
  • this invention consists of three jaws.
  • the purpose of this invention is to allow the three jaws to easily grasp the stent keeping it firmly around themselves, and then remove it in a precise, safe and effective way.
  • the three jaws arranged at the end of the forceps as the vertices of a hypothetical equilateral triangle, present at the extremity a tooth for the grip.
  • the forceps is thus introduced into the rigid bronchoscope as a standard endoscopic forceps. Its shank allows the extraction of localized stent even in the airways more distal to the trachea as the right main and left main bronchus. This forceps is kept rigid and therefore easily adjustable; yet, it occupies only partially the operative channel of the rigid bronchoscope, thus allowing the simultaneous introduction of further instruments such as aspirator and optical fiber.
  • the three jaws are opened so as to surround the stent for half its length, closing, at a later time, so that the stent remains crushed and firmly anchored to the same, thus allowing easy extraction by means of a rigid bronchoscope.
  • the aforesaid aim is achieved with the creation, experimentation and realization of a forceps with three jaws in accordance with the single claim.
  • FIG. 1 illustrates a forceps for extraction of airway stent in accordance with the principles of the present invention when the jaws are in an open position
  • FIG. 2 illustrates a forceps for extraction of airway stent in accordance with the principles of the present invention when the jaws are in a closed position
  • Fig. 3 illustrates an enlarged top view of the inner face of each of the three jaws of the forceps
  • Fig. 4 illustrates an enlarged side view of the inner face of each of the three jaws of the forceps and the tooth located at the extremity of each jaw;
  • Fig. 5 is a schematic diagrams illustrating a gradual opening of the three jaws near a stent
  • Fig. 6 illustrates the three jaws, in an open position, that grasp the stent keeping it firmly around themselves;
  • Fig. 7 illustrates the stent closed between the three jaws of the forceps, firmly held by them with its caliber reduced;
  • Fig. 8 is a schematic diagrams illustrating the easy extraction of the stent crushed and firmly anchored to the three jaws;
  • FIG. 9 is an enlarged perspective view of the three jaws in a closed position
  • FIG. 10 is an enlarged perspective view of the three jaws in an open position.
  • Fig. 1 and 2 The three-jaws forceps designed for the extraction of airway stent is illustrated in Fig. 1 and 2 where is indicated in its entirety.
  • the forceps comprises some elements that are completely similar to other endoscopic forceps: a distal handle (1) consisting of two handle rings (1) in which the surgeon inserts two fingers of the hand, allows the opening and closing of the three proximal jaws (5).
  • the handle (1) is then provided with a lock system (2) which allows locking of the three jaws (5) so that the stent remains firmly fixed between the jaws (5).
  • the handle (1) there is a wheel (3) which allows the three jaws (5) to be turned clockwise or anticlockwise proximal to the forceps; this movement is useful in orientating the three jaws (5) open to surround the stent.
  • the rotation of the stent is made to rotate it and facilitate its mobilization from possible adhesions and therefore the extraction.
  • Fig. 3 and 4 are an enlarged top and side view of the inner surface of each jaw.
  • Fig. 3 and 4 illustrate the inner face that comes into contact with the stent and has a wavy indentation (6) and a tooth situated at its proximal end (7), aiming at hold on the stent tightly to the jaws (as also illustrated in Fig. 6, 7 e 8).
  • Fig. 9 and 10 illustrate an enlarged perspective view of the jaws of the endoscopic forceps in greater detail, both closed and open.
  • the three jaws (5) are geometrically arranged at the vertices of an imaginary equilateral triangle (Fig. 10). When they are closed, the tooth of each jaw matches that of the other jaws (Fig. 9). This mechanism allows easy insertion of the forceps into the rigid bronchoscope and a safe progression in the airways up to the level of the stent position.
  • the three jaws (5) once opened, progress along the sides of the stent until wrapping up a section of the stent. Then, the three jaws close, at a later time, so that the stent remains crushed and firmly anchored to them, in order to press the stent and keep it firmly anchored. Then the stent will be easily removed (Fig. 8).

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

La présente invention concerne un forceps endoscopique à trois mâchoires (5) pour l'extraction de stents en silicone trachéobronchial placés pour le traitement endoscopique de la sténose de la trachée ou des bronches, qui peuvent être avantageusement utilisés dans des applications anatomiques et chirurgicales. L'invention est caractérisée par trois mâchoires (5) à son extrémité distale, disposées comme les sommets d'un triangle équilatéral hypothétique. A l'extrémité de chaque mâchoire, une dent (7) est placée, afin de permettre l'extraction du stent (8) facile, sûre et efficace, en le maintenant pressé et fermement ancré entre les trois mâchoires (5) du forceps.
PCT/IT2018/000005 2018-01-16 2018-01-16 Forceps endoscopique à trois mâchoires WO2019142215A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/IT2018/000005 WO2019142215A1 (fr) 2018-01-16 2018-01-16 Forceps endoscopique à trois mâchoires

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/IT2018/000005 WO2019142215A1 (fr) 2018-01-16 2018-01-16 Forceps endoscopique à trois mâchoires

Publications (1)

Publication Number Publication Date
WO2019142215A1 true WO2019142215A1 (fr) 2019-07-25

Family

ID=62028077

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IT2018/000005 WO2019142215A1 (fr) 2018-01-16 2018-01-16 Forceps endoscopique à trois mâchoires

Country Status (1)

Country Link
WO (1) WO2019142215A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN118058802A (zh) * 2024-04-08 2024-05-24 中国人民解放军空军军医大学 一种协同式支气管镜及支气管异物取出器

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6187016B1 (en) * 1999-09-14 2001-02-13 Daniel G. Hedges Stent retrieval device
US20020120277A1 (en) * 2001-02-12 2002-08-29 Hauschild Sidney F. Foreign body retrieval device and method
US20040034380A1 (en) * 2001-06-29 2004-02-19 Woolfson Steven B. Method and apparatus for resecting and replacing an aortic valve
US20130085494A1 (en) * 2011-09-30 2013-04-04 Ethicon Endo-Surgery, Inc. Laparoscopic device with three jaws
US20170056038A1 (en) * 2015-08-26 2017-03-02 Ethicon Endo-Surgery, Llc Dissecting surgical jaws

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6187016B1 (en) * 1999-09-14 2001-02-13 Daniel G. Hedges Stent retrieval device
US20020120277A1 (en) * 2001-02-12 2002-08-29 Hauschild Sidney F. Foreign body retrieval device and method
US20040034380A1 (en) * 2001-06-29 2004-02-19 Woolfson Steven B. Method and apparatus for resecting and replacing an aortic valve
US20130085494A1 (en) * 2011-09-30 2013-04-04 Ethicon Endo-Surgery, Inc. Laparoscopic device with three jaws
US20170056038A1 (en) * 2015-08-26 2017-03-02 Ethicon Endo-Surgery, Llc Dissecting surgical jaws

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN118058802A (zh) * 2024-04-08 2024-05-24 中国人民解放军空军军医大学 一种协同式支气管镜及支气管异物取出器

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